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Individual
MS. HEATHER CONROY SELIS
Active
Individual
MS. HEATHER CONROY SELIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
093006586N2
OR
2080A0000X
Pediatric Adolescent Medicine Physician
93006586NZ
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500639814
—
OR
Enumeration date
06/20/2008
Last updated
02/27/2012
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